Texas lake and river swimmers must be aware of potential health risks

WACO, Texas – May 26, 2020 – Summer is on its way, along with increasing temperatures and water conditions that are suitable for the spread of an uncommon but usually fatal illness that can occur when water is forced up your nose, usually during swimming or water recreation.

Primary amebic meningoencephalitis or PAM is a rare brain infection caused when swimmers come in contact with Naegleria fowleri, an amoeba found in freshwater and soil. The amoeba thrives in freshwater that is warmer than 80 degrees and stagnant or slow-moving. 

PAM only infects people when water containing the amoeba enters through the nose through activities such as diving, water skiing or jumping into freshwater. The amoeba travels up the nose, making its way into the brain along the olfactory nerve, destroying brain tissue.

The infection cannot be spread from person to person or by drinking contaminated water. It is most common in children. 

Those infected with PAM will usually start showing symptoms within five days following exposure. Symptoms can often be mistaken for the flu or bacterial meningitis, as they include headache, fever, nausea or vomiting.  As the disease develops, symptoms can advance to loss of balance, stiff neck, seizures and hallucinations. The disease progresses quickly once the symptoms begin and usually causes death within two weeks of the initial infection.

While the disease is rare, there have been cases reported in Texas within the Brazos River basin.  The cases identified thus far have almost always been fatal. According to the Centers for Disease Control and Prevention, only 4 people in the U.S. out of 145 cases identified have survived the infection from 1962 to 2018.

The Texas Department of State Health Services (TDSHS) reports that most PAM infections occur when temperatures are hot and water levels are lower. As we head into what is expected to be an average hot Texas summer, be aware and know that there are safety precautions that can be followed.

The only way to completely prevent contracting PAM is to not participate in water-related activities. If you do decide to participate, use nose clips or hold your nose shut while jumping into the water. With the amoeba often found in soil, it’s best to avoid stirring up underwater sediment.

Texas Health and Human Services also recommend avoiding water activities in bodies of warm freshwater with low water levels. Avoid stagnant or polluted water and take “No Swimming” signs seriously. Swimming pools and hot tubs that are properly cleaned, maintained and chlorinated are generally safe, as is saltwater.

If water does get up your nose while swimming in warm freshwater, monitor yourself for flu-like symptoms. If you do start showing symptoms, going to a medical professional and informing them that you may have been exposed to the amoeba could save your life. There are specific tests that must be conducted to identify the PAM disease before treatment may begin. If medical professionals are not aware of the potential exposure to the amoeba, valuable time may be lost before a proper diagnosis is made, and life-saving treatment may begin.   

By being aware and educating others, we can all stay safe this summer on the Brazos River basin.

For more information about PAM, contact your local county health department or the Texas Department of State Health Services at 512-776-7111. For toll-free, please dial 1-888-963-7111.